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PARADISE LAKE SENIOR CARE HOME LLC NPI 1932508868


NPI Information

NPI: 1932508868
Provider Name: PARADISE LAKE SENIOR CARE HOME, LLC
Classification: Custodial Care Facility - 311ZA0620X
Entity Type: Organization

Specialization: Adult Care Home

Address:
10121 219TH ST SE
SNOHOMISH, WA
ZIP 98296
Phone: (425) 761-7739
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PARADISE LAKE SENIOR CARE HOME, LLC is an adult care home custodial care facility in Snohomish, WA. The provider is a custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment. PARADISE LAKE SENIOR CARE HOME, LLC NPI is 1932508868. The provider is registered as an organization entity type.

The provider's business location address is:

10121 219TH ST SE
SNOHOMISH, WA
ZIP 98296-941
Phone: (425) 761-7739
Fax: (360) 668-5297

The provider's authorized official is Theresa Frigillana .
The authorized official title is Afh Provider and has the following contact phone number (425) 761-7739.

The enumeration date for this NPI number is 8/15/2014 and was last updated on 8/15/2014.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1311ZA0620XCustodial Care FacilityAdult Care Home751477WASHINGTONYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1515305MEDICAIDWASHINGTON

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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